United States: Health Care: What's On The Radar For This Congressional Work Period

The next Hill work period basically runs from February 22
to March 18. As Congress returns, here's a brief look at the
pending health care issues on the radar for this work period.

Atmospherics

As much as health care geeks think the world revolves around
health care, there are other issues in play that can affect
consideration of health care issues. First, there is consideration
of the FY 2017 Budget. It is unclear whether House and Senate
Republicans are ready to move forward with a budget this year (the
2015 year-end deal deemed the process for this year complete). Any
budget is certain to have health related provisions. While not
incredibly influential for the process this year, a budget exercise
employs resources that could be used on other issues.

The more politically relevant issue is the Senate's reaction
to the Supreme Court vacancy created by the death of Justice
Scalia. At some point this year, it will become clear that the
Senate is no longer able to consider bills of even remote
consequence because it is an election year. The battle over the
nomination will increase the political temperature in the Senate.
It is not clear if it will rise to the level of halting progress on
other issues.

Issues

Opioids — The Senate is inching closer to
a floor vote on the Comprehensive Addiction and Recovery Act
(CARA), which would enable the Attorney General to award grants to
states to address opioid and heroin abuse. Whether this legislation
can pass through both chambers of Congress remains to be seen, but
we should get that answer in the next work period.

FDA Nominee — Senate Majority Leader
Mitch McConnell filed a motion before the recess to proceed with
the nomination of Robert Califf to be FDA Commissioner, despite
objections remaining from three Democratic Senators. McConnell has
successfully driven a wedge between the Administration and the
Democrats in the Senate, forcing Minority Leader Harry Reid to
decide between allowing a vote on the Administration's pick or
standing up for three in his own caucus to block the
Republican-controlled Senate from confirming the President's
nominee. Earlier this month, Dr. Califf and the FDA called for a
review of agency opioid policies, but Democratic Senators appear to
be seeking more concrete action.

Mental Health — A legislative package to
address mental health access is being negotiated between the Senate
Committee on Health, Education, Labor, and Pensions (HELP) and the
White House, with the goal of getting a bill before the committee
sometime next month. The goal is to encompass a broad range of
proposals into one package. The Senate will still have to address
other mental health efforts including Majority Whip John
Cornyn's (R-TX) mental health initiative which has objections
from Democrats over certain gun provisions. It also signals that
the effort in the House led by Rep. Tim Murphy has stalled.
Ultimately, the linkage between mental health and gun violence as
this debate moves forward will determine prospects for passage.

Innovation Bills — Following a first markup during which
each piece of legislation was approved out of committee but
Democrats raised concerns about future markups, the Senate HELP
Committee will convene March 9th to review another series of bills.
While Chairman Lamar Alexander expressed openness to increased
funding for NIH and FDA, getting a package out of committee without
a spending guarantee seems highly unlikely. The pessimism among
health policy observers is palpable, as some already look to next
year's reauthorization of the Generic Drug User Free Amendments
(GDUFA) as the vehicle to resolve differences if a larger package
of innovation bills does not move in short order. The next series
of bills deal with medical device regulations, priority review
vouchers, and advancing research for rare diseases.

Chronic Care — The Senate Finance Committee is hoping to
have a legislative package unveiled in the next work period,
although Senator Johnny Isakson's (R-GA) spokesman said there
is no firm timetable for the legislative package. Should a package
be unveiled next month, its review by the Congressional Budget
Office will likely forecast how quickly the legislation is
considered by the committee. The committee may look to extend the
Independence at Home Demonstration, a move which proponents say
will save money.

MA Lobbying — Late last month, AHIP announced it was
joining the lobbying effort against cuts to Medicare Advantage.
This is a familiar two-step for Medicare Advantage proponents, who
successfully lobbied against a rate reduction last year and have
been successful in previous years. Last week, a bipartisan group of
over 300 Representatives wrote to CMS urging them to avoid further
cuts to Medicare Advantage in 2017, and the next work period will
likely feature a lobbying effort to preface the 2017 Advance Notice
and Draft Call Letter for Medicare Advantage and Part D, which is
expected in early April.

The content of this article is intended to provide a general
guide to the subject matter. Specialist advice should be sought
about your specific circumstances.

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